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Otolaryngology (ENT)93 papers

Pharyngotonsillitis

Last edited: 4/13/2026

Overview

Pharyngotonsillitis is an inflammatory and infectious condition affecting the tonsils in the oropharynx, commonly caused by group A beta-hemolytic streptococci (GABHS) and, increasingly, Fusobacterium necrophorum, particularly in adolescents and young adults 1 3 4 10.

Diagnosis

Clinical Symptoms: Fever, sore throat, tonsillar swelling, and exudates are common 1 3.

Laboratory Tests: Rapid antigen detection tests (RADT) for GABHS are useful but not infallible 29 36.

Culture: Essential for confirming GABHS and identifying other pathogens like Fusobacterium necrophorum 3 36.

Cytokine Analysis: Elevated cytokines produced by GABHS can support diagnosis 12.

Differentiation: Symptoms predictive of Fusobacterium necrophorum include severe unilateral tonsillitis, tender anterior cervical lymphadenopathy, and absence of cough 1.

Management

First-Line Treatment:

- GABHS: Penicillin V (250 mg QID for 10 days) or amoxicillin (50 mg/kg/day divided TID for 10 days) 7 28 30. - Fusobacterium necrophorum: Clindamycin (300 mg BID) or amoxicillin/clavulanate (1 g BID) may be considered 4 30 38.

Adjunctive Treatments:

- Pain Control: Paracetamol and NSAIDs (e.g., ketoprofen) for symptomatic relief 18. - Probiotics: Considered as adjuncts but evidence is limited 14. - Photodynamic Therapy: Emerging for recurrent cases 2. - Bacteriotherapy: Streptococcus salivarius and Streptococcus oralis oral sprays show promise in reducing recurrences 8.

Special Populations

Pediatrics: Short-course regimens (5 days) with cefpodoxime or amoxicillin/clavulanate are effective and cost-saving 31 61.

Comorbidities: Presence of beta-lactamase-producing bacteria may necessitate alternative antibiotics like clindamycin 26.

Elderly: No specific guidelines diverge; general principles apply with caution regarding antibiotic resistance 3 30.

Key Recommendations

Empiric Antibiotic Therapy: Consider Fusobacterium necrophorum in adolescents and young adults with severe unilateral tonsillitis; empirical clindamycin may be warranted 4 (Evidence: Moderate).

Treatment Duration for GABHS: Ten-day courses of penicillin V or amoxicillin are standard, but short-course regimens (5 days) with cefpodoxime or amoxicillin/clavulanate are effective alternatives 7 30 61 (Evidence: Moderate).

Rapid Antigen Detection Tests (RADT): Use RADT for GABHS but confirm with culture due to potential false negatives 29 36 (Evidence: Moderate).

Management of Recurrent Cases: Consider bacteriotherapy with probiotics like Streptococcus salivarius for recurrent streptococcal pharyngotonsillitis 8 (Evidence: Weak).

Non-Adherence Awareness: Monitor adherence to guidelines to prevent antibiotic misuse and resistance 13 (Evidence: Moderate).

References

1 Pagels J, Torisson G, Wasserstrom L, Hedin K, Holm K, Nygren D. Symptoms predictive of Fusobacterium necrophorum pharyngotonsillitis - an observational study of cases presenting to hospitals in Southern Sweden. European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology 2024. link 2 Duarte LMP, Santiago IDD, Blanco KC, Bagnato VS. Use of photodynamic therapy to combat recurrent pharyngotonsillitis: Three case reports. Photodiagnosis and photodynamic therapy 2024. link 3 Nygren D, Wasserstrom L, Holm K, Torisson G. Associations Between Findings of Fusobacterium necrophorum or β-Hemolytic Streptococci and Complications in Pharyngotonsillitis-A Registry-Based Study in Southern Sweden. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2023. link 4 Centor RM, Huddle TS. Should the risk of Fusobacterium necrophorum pharyngotonsillitis influence prescribing empiric antibiotics for sore throats in adolescents and young adults?. Anaerobe 2021. link 5 Nygren D, Brorson E, Musonda M, Wasserstrom L, Johansson Å, Holm K. Geographical differences in tonsillar carriage rates of Fusobacterium necrophorum - A cross-sectional study in Sweden and Zambia. Anaerobe 2021. link 6 Stivala A, Genovese C, Bonaccorso C, Di Salvatore V, Petronio Petronio G, Garozzo A et al.. Comparison of Cell Culture with Three Conventional Polymerase Chain Reactions for Detecting Chlamydophila pneumoniae in Adult's Pharyngotonsillitis. Current microbiology 2020. link 7 Skoog Ståhlgren G, Tyrstrup M, Edlund C, Giske CG, Mölstad S, Norman C et al.. Penicillin V four times daily for five days versus three times daily for 10 days in patients with pharyngotonsillitis caused by group A streptococci: randomised controlled, open label, non-inferiority study. BMJ (Clinical research ed.) 2019. link 8 Andaloro C, Santagati M, Stefani S, La Mantia I. Bacteriotherapy with Streptococcus salivarius 24SMB and Streptococcus oralis 89a oral spray for children with recurrent streptococcal pharyngotonsillitis: a randomized placebo-controlled clinical study. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 2019. link 9 Munck H, Jørgensen AW, Klug TE. Antibiotics for recurrent acute pharyngo-tonsillitis: systematic review. European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology 2018. link 10 Holm K, Bank S, Nielsen H, Kristensen LH, Prag J, Jensen A. The role of Fusobacterium necrophorum in pharyngotonsillitis - A review. Anaerobe 2016. link 11 Andre M, Gröndal H, Strandberg EL, Brorsson A, Hedin K. Uncertainty in clinical practice - an interview study with Swedish GPs on patients with sore throat. BMC family practice 2016. link 12 Leão SC, Leal IO, Rocha HM, Rodrigues TM. Evaluation of cytokines produced by β-hemolytic streptococcus in acute pharyngotonsillitis. Brazilian journal of otorhinolaryngology 2015. link 13 Rico-Ferreira P, Palazón-Bru A, Calvo-Pérez M, Gil-Guillén VF. Nonadherence to guidelines for prescribing antibiotic therapy to patients with tonsillitis or pharyngotonsillitis: a cross-sectional study. Current medical research and opinion 2015. link 14 Gilbey P, Livshits L, Sharabi-Nov A, Avraham Y, Miron D. Probiotics in addition to antibiotics for the treatment of acute tonsillitis: a randomized, placebo-controlled study. European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology 2015. link 15 Kosikowska U, Korona-Głowniak I, Niedzielski A, Malm A. Nasopharyngeal and Adenoid Colonization by Haemophilus influenzae and Haemophilus parainfluenzae in Children Undergoing Adenoidectomy and the Ability of Bacterial Isolates to Biofilm Production. Medicine 2015. link 16 Culqui DR, Manzanares-Laya S, Van Der Sluis SL, Fanlo AA, Comas RB, Rossi M et al.. Group A β-hemolytic streptococcal pharyngotonsillitis outbreak. Revista de saude publica 2014. link 17 Morais VM, Orsi AR, Maranhão FC, Castro TM, Castro KC, Silva DM. Prevalence of β-hemolytic Streptococcus in children with special health care needs. Brazilian journal of otorhinolaryngology 2012. link 18 Ruperto N, Carozzino L, Jamone R, Freschi F, Picollo G, Zera M et al.. A randomized, double-blind, placebo-controlled trial of paracetamol and ketoprofren lysine salt for pain control in children with pharyngotonsillitis cared by family pediatricians. Italian journal of pediatrics 2011. link 19 Togawa A, Hotomi M, Tamura S, Yamanaka N. Clinical scoring system of acute pharyngotonsillitis. Advances in oto-rhino-laryngology 2011. link 20 Brook I, Gober AE. Rate of eradication of group A beta-hemolytic streptococci in children with pharyngo-tonsillitis by amoxicillin and cefdinir. International journal of pediatric otorhinolaryngology 2009. link 21 Suzumoto M, Hotomi M, Billal DS, Fujihara K, Harabuchi Y, Yamanaka N. A scoring system for management of acute pharyngo-tonsillitis in adults. Auris, nasus, larynx 2009. link 22 Brook I, Gober AE. Concurrent influenza A and group A beta-hemolytic streptococcal pharyngotonsillitis. The Annals of otology, rhinology, and laryngology 2008. link 23 Pereira LMP, Juman S, Bekele I, Seepersadsingh N, Adesiyun AA. Selected bacterial recovery in Trinidadian children with chronic tonsillar disease. Brazilian journal of otorhinolaryngology 2008. link30152-X) 24 Funahashi K, Nakane K, Yasuda N, Suzuki M, Narita A, Arai N et al.. T serotypes and antimicrobial susceptibilities of group A streptococcus isolates from pediatric pharyngotonsillitis. Japanese journal of infectious diseases 2008. link 25 Jain A, Shukla VK, Tiwari V, Kumar R. Antibiotic resistance pattern of group-a beta-hemolytic streptococci isolated from north Indian children. Indian journal of medical sciences 2008. link 26 Brook I, Gober AE. Failure to eradicate streptococci and beta-lactamase producing bacteria. Acta paediatrica (Oslo, Norway : 1992) 2008. link 27 Mora R, Dellepiane M, Crippa B, Salami A. Ribosomal therapy in the prophylaxis of recurrent pharyngotonsillitis in children. International journal of pediatric otorhinolaryngology 2007. link 28 Brook I, Dohar JE. Management of group A beta-hemolytic streptococcal pharyngotonsillitis in children. The Journal of family practice 2006. link 29 Araujo Filho BC, Imamura R, Sennes LU, Sakae FA. Role of rapid antigen detection test for the diagnosis of group-A beta-hemolytic streptococcus in patients with pharyngotonsillitis. Brazilian journal of otorhinolaryngology 2006. link30027-6) 30 Mahakit P, Vicente JG, Butt DI, Angeli G, Bansal S, Zambrano D. Oral clindamycin 300 mg BID compared with oral amoxicillin/clavulanic acid 1 g BID in the outpatient treatment of acute recurrent pharyngotonsillitis caused by group a beta-hemolytic streptococci: an international, multicenter, randomized, investigator-blinded, prospective trial in patients between the ages of 12 and 60 years. Clinical therapeutics 2006. link 31 Araujo Filho BC, Imamura R, Sennes LU, Sakae FA. Role of rapid antigen detection test for the diagnosis of group A beta-hemolytic streptococcus in patients with pharyngotonsillitis. Brazilian journal of otorhinolaryngology 2005. link31306-9) 32 Pandolfini C, Campi R, Clavenna A, Cazzato T, Bonati M. Italian paediatricians and off-label prescriptions: loyal to regulatory or guideline standards?. Acta paediatrica (Oslo, Norway : 1992) 2005. link 33 Orrling A, Kamme C, Stjernquist-Desatnik A. Penicillin V, loracarbef and clindamycin in tonsillar surface fluid during acute group A streptococcal pharyngotonsillitis. Scandinavian journal of infectious diseases 2005. link 34 Marouni MJ, Barzilai A, Keller N, Rubinstein E, Sela S. Intracellular survival of persistent group A streptococci in cultured epithelial cells. International journal of medical microbiology : IJMM 2004. link 35 Cocuzza CE, Lanzafame A, Sisto F, Broccolo F, Mattina R. Prevalence of the internalization-associated gene prtF1 in a bacterial population of Streptococcus pyogenes isolated from children with acute pharyngotonsillitis before and after antibiotic therapy. Microbial drug resistance (Larchmont, N.Y.) 2004. link 36 Santos O, Weckx LL, Pignatari AC, Pignatari SS. Detection of Group A beta-hemolytic Streptococcus employing three different detection methods: culture, rapid antigen detecting test, and molecular assay. The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases 2003. link 37 Haczyński J, Chmielik M, Bien S, Kawalski H, Zawadzka-Głos L, Mierzwa T et al.. A comparative study of cefaclor vs amoxicillin/clavulanate in pediatric pharyngotonsillitis. Medical science monitor : international medical journal of experimental and clinical research 2003. link 38 Mora R, Salami A, Mora F, Cordone MP, Ottoboni S, Passali GC et al.. Efficacy of cefpodoxime in the prophylaxis of recurrent pharyngotonsillitis. International journal of pediatric otorhinolaryngology 2003. link 39 Brook I. Antibacterial therapy for acute group a streptococcal pharyngotonsillitis: short-course versus traditional 10-day oral regimens. Paediatric drugs 2002. link 40 Siddiqui SJ, Awan A, Ekangakic A, Stocks JM, Sheikh GA, Ahmad TM et al.. An evaluation of cefaclor in Pakistani children with pharyngotonsillitis. JPMA. The Journal of the Pakistan Medical Association 2002. link 41 Cascone C, Santagati M, Noviello S, Iannelli F, Esposito S, Pozzi G et al.. Macrolide-resistance genes in clinical isolates of Streptococcus pyogenes. Microbial drug resistance (Larchmont, N.Y.) 2002. link 42 Stenfors LE, Bye HM, Vorland LH. Remarkable attachment of lactoferrin to Streptococcus pyogenes during acute pharyngotonsillitis. Acta oto-laryngologica 2001. link 43 Avanzini C, Bosio K, Volpe G, Dotti G, Savoia D. Streptococcus pyogenes collected in Torino (northwest Italy) between 1983 and 1998: survey of macrolide resistance and trend of genotype by RAPD. Microbial drug resistance (Larchmont, N.Y.) 2000. link 44 Yoda K, Sata T, Kurata T, Aramaki H. Oropharyngotonsillitis associated with nonprimary Epstein-Barr virus infection. Archives of otolaryngology--head & neck surgery 2000. link 45 Jasir A, Noorani A, Mirsalehian A, Schalen C. Isolation rates of Streptococcus pyogenes in patients with acute pharyngotonsillitis and among healthy school children in Iran. Epidemiology and infection 2000. link 46 Savoia D, Avanzini C, Bosio K, Volpe G, Carpi D, Dotti G et al.. Macrolide resistance in group A streptococci. The Journal of antimicrobial chemotherapy 2000. link 47 Brook I, Gober AE. Interference by aerobic and anaerobic bacteria in children with recurrent group A beta-hemolytic streptococcal tonsillitis. Archives of otolaryngology--head & neck surgery 1999. link 48 Lilja M, Silvola J, Räisänen S, Stenfors LE. Where are the receptors for Streptococcus pyogenes located on the tonsillar surface epithelium?. International journal of pediatric otorhinolaryngology 1999. link00221-9) 49 Falck G, Grahn-Håkansson E, Holm SE, Roos K, Lagergren L. Tolerance and efficacy of interfering alpha-streptococci in recurrence of streptococcal pharyngotonsillitis: a placebo-controlled study. Acta oto-laryngologica 1999. link 50 Brook I, Gober AE. Persistence of group A beta-hemolytic streptococci in toothbrushes and removable orthodontic appliances following treatment of pharyngotonsillitis. Archives of otolaryngology--head & neck surgery 1998. link 51 Ebenfelt A, Ericson LE, Lundberg C. Acute pharyngotonsillitis is an infection restricted to the crypt and surface secretion. Acta oto-laryngologica 1998. link 52 Neeman R, Keller N, Barzilai A, Korenman Z, Sela S. Prevalence of internalisation-associated gene, prtF1, among persisting group-A streptococcus strains isolated from asymptomatic carriers. Lancet (London, England) 1998. link12452-7) 53 Roos K, Larsson P. Loracarbef versus phenoxymethylpenicillin in the treatment of recurrent streptococcal pharyngotonsillitis. Scandinavian journal of infectious diseases 1997. link 54 Osterlund A, Popa R, Nikkilä T, Scheynius A, Engstrand L. Intracellular reservoir of Streptococcus pyogenes in vivo: a possible explanation for recurrent pharyngotonsillitis. The Laryngoscope 1997. link 55 Cocuzza CE, Mattina R, Mazzariol A, Orefici G, Rescaldani R, Primavera A et al.. High incidence of erythromycin-resistant Streptococcus pyogenes in Monza (North Italy) in untreated children with symptoms of acute pharyngo-tonsillitis: an epidemiological and molecular study. Microbial drug resistance (Larchmont, N.Y.) 1997. link 56 Orrling A, Stjernquist-Desatnik A, Schalén C. Clindamycin in recurrent group A streptococcal pharyngotonsillitis--an alternative to tonsillectomy?. Acta oto-laryngologica 1997. link 57 Cordero L, Torre W, Freire D. Descending necrotizing mediastinitis and respiratory distress syndrome treated by aggressive surgical treatment. The Journal of cardiovascular surgery 1996. link 58 Roos K, Holm SE, Grahn-Håkansson E, Lagergren L. Recolonization with selected alpha-streptococci for prophylaxis of recurrent streptococcal pharyngotonsillitis--a randomized placebo-controlled multicentre study. Scandinavian journal of infectious diseases 1996. link 59 Benson JM, Arnold J, Manning SC, Coleman DL, Sides GD, Conforti PM et al.. Tonsillar tissue penetration of dirithromycin after multiple doses. Journal of clinical pharmacology 1996. link 60 Orrling A, Stjernquist-Desatnik A, Schalén C, Kamme C. Treatment failure in streptococcal pharyngotonsillitis. An attempt to identify penicillin tolerant Streptococcus pyogenes. Scandinavian journal of infectious diseases 1996. link 61 Pelc A, Portier H, Gehanno P, Fiessinger S, Ichou F. Cost saving of 5-day therapy with cefpodoxime proxetil versus standard 10-day beta-lactam therapy for recurrent pharyngotonsillitis in adults. A prospective general practice study. PharmacoEconomics 1996. link 62 Ebenfelt A, Lundberg C. Cellular defence in surface secretion in acute pharyngotonsillitis. Acta oto-laryngologica 1996. link 63 Osterlund A, Engstrand L. Intracellular penetration and survival of Streptococcus pyogenes in respiratory epithelial cells in vitro. Acta oto-laryngologica 1995. link 64 Osterlund A. Are penicillin treatment failures in Arcanobacterium haemolyticum pharyngotonsillitis caused by intracellularly residing bacteria?. Scandinavian journal of infectious diseases 1995. link 65 Gervaix A, Brighi L, Halpérin DS, Suter S. Cefetamet pivoxil in the treatment of pharyngotonsillitis due to group A beta-hemolytic streptococci: preliminary report. Journal of chemotherapy (Florence, Italy) 1995. link 66 Osterlund A, Engstrand L. DNA fingerprinting of Streptococcus pyogenes from patients with recurrent pharyngotonsillitis by means of random amplified Polymorphic DNA analysis. Scandinavian journal of infectious diseases 1995. link 67 Brook I, Gober AE, Leyva F. In vitro and in vivo effects of penicillin and clindamycin on expression of group A beta-hemolytic streptococcal capsule. Antimicrobial agents and chemotherapy 1995. link 68 Ebenfelt A, Lundberg C. Bacterial invasion of the tonsillar tissues in acute pharyngotonsillitis and in the adenoid: a preliminary study. Clinical otolaryngology and allied sciences 1994. link 69 Orrling A, Stjernquist-Desatnik A, Schalén C, Kamme C. Clindamycin in persisting streptococcal pharyngotonsillitis after penicillin treatment. Scandinavian journal of infectious diseases 1994. link 70 Galetti G, Dallari S. Efficacy and tolerability of brodimoprim in pharyngotonsillitis in children. Journal of chemotherapy (Florence, Italy) 1993. link 71 Karpathios T, Drakonaki S, Zervoudaki A, Coupari G, Fretzayas A, Kremastinos J et al.. Arcanobacterium haemolyticum in children with presumed streptococcal pharyngotonsillitis or scarlet fever. The Journal of pediatrics 1992. link81903-1) 72 Thamlikitkul V, Dechatiwongse T, Theerapong S, Chantrakul C, Boonroj P, Punkrut W et al.. Efficacy of Andrographis paniculata, Nees for pharyngotonsillitis in adults. Journal of the Medical Association of Thailand = Chotmaihet thangphaet 1991. link 73 Esposito S, D'Errico G, Montanaro C. Oral ciprofloxacin for treatment of acute bacterial pharyngotonsillitis. Journal of chemotherapy (Florence, Italy) 1990. link 74 Hoffmann S. Detection of group A streptococcal antigen from throat swabs with five diagnostic kits in general practice. Diagnostic microbiology and infectious disease 1990. link90061-y) 75 Portier H, Chavanet P, Gouyon JB, Guetat F. Five day treatment of pharyngotonsillitis with cefpodoxime proxetil. The Journal of antimicrobial chemotherapy 1990. link 76 Strömberg A, Schwan A, Cars O. Bacteriological and serological aspects of group A streptococcal pharyngotonsillitis caused by group A streptococci. European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology 1988. link 77 Hoffmann S, Henrichsen J. Detection of group A streptococcal antigen from throat swabs by use of a latex agglutination test kit in general practice. Acta pathologica, microbiologica, et immunologica Scandinavica. Section B, Microbiology 1987. link 78 Strömberg A, Schwan A. A comparison between a commercial coagglutination test and conventional throat culture for the detection of group A streptococci in throat swabs. Scandinavian journal of infectious diseases 1986. link 79 Principi N, Marchisio P, Sher D, Boccazzi A, Moresco RC, Viola G et al.. Control of antibiotic therapy in paediatric patients. II. Appropriateness of antibiotic choice in selected diseases. European journal of clinical pharmacology 1981. link

Original source

[1]
Symptoms predictive of Fusobacterium necrophorum pharyngotonsillitis - an observational study of cases presenting to hospitals in Southern Sweden. — Pagels J, Torisson G, Wasserstrom L, Hedin K, Holm K, Nygren D European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology (2024)
[2]
Use of photodynamic therapy to combat recurrent pharyngotonsillitis: Three case reports. — Duarte LMP, Santiago IDD, Blanco KC, Bagnato VS Photodiagnosis and photodynamic therapy (2024)
[3]
Associations Between Findings of Fusobacterium necrophorum or β-Hemolytic Streptococci and Complications in Pharyngotonsillitis-A Registry-Based Study in Southern Sweden. — Nygren D, Wasserstrom L, Holm K, Torisson G Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (2023)
[4]
Should the risk of Fusobacterium necrophorum pharyngotonsillitis influence prescribing empiric antibiotics for sore throats in adolescents and young adults? — Centor RM, Huddle TS Anaerobe (2021)
[5]
Geographical differences in tonsillar carriage rates of Fusobacterium necrophorum - A cross-sectional study in Sweden and Zambia. — Nygren D, Brorson E, Musonda M, Wasserstrom L, Johansson Å, Holm K Anaerobe (2021)
[6]
Comparison of Cell Culture with Three Conventional Polymerase Chain Reactions for Detecting Chlamydophila pneumoniae in Adult's Pharyngotonsillitis. — Stivala A, Genovese C, Bonaccorso C, Di Salvatore V, Petronio Petronio G, Garozzo A et al. Current microbiology (2020)
[7]
Penicillin V four times daily for five days versus three times daily for 10 days in patients with pharyngotonsillitis caused by group A streptococci: randomised controlled, open label, non-inferiority study. — Skoog Ståhlgren G, Tyrstrup M, Edlund C, Giske CG, Mölstad S, Norman C et al. BMJ (Clinical research ed.) (2019)
[8]
Bacteriotherapy with Streptococcus salivarius 24SMB and Streptococcus oralis 89a oral spray for children with recurrent streptococcal pharyngotonsillitis: a randomized placebo-controlled clinical study. — Andaloro C, Santagati M, Stefani S, La Mantia I European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (2019)
[9]
Antibiotics for recurrent acute pharyngo-tonsillitis: systematic review. — Munck H, Jørgensen AW, Klug TE European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology (2018)
[10]
The role of Fusobacterium necrophorum in pharyngotonsillitis - A review. — Holm K, Bank S, Nielsen H, Kristensen LH, Prag J, Jensen A Anaerobe (2016)
[11]
Uncertainty in clinical practice - an interview study with Swedish GPs on patients with sore throat. — Andre M, Gröndal H, Strandberg EL, Brorsson A, Hedin K BMC family practice (2016)
[12]
Evaluation of cytokines produced by β-hemolytic streptococcus in acute pharyngotonsillitis. — Leão SC, Leal IO, Rocha HM, Rodrigues TM Brazilian journal of otorhinolaryngology (2015)
[13]
Nonadherence to guidelines for prescribing antibiotic therapy to patients with tonsillitis or pharyngotonsillitis: a cross-sectional study. — Rico-Ferreira P, Palazón-Bru A, Calvo-Pérez M, Gil-Guillén VF Current medical research and opinion (2015)
[14]
Probiotics in addition to antibiotics for the treatment of acute tonsillitis: a randomized, placebo-controlled study. — Gilbey P, Livshits L, Sharabi-Nov A, Avraham Y, Miron D European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology (2015)
[15]
Nasopharyngeal and Adenoid Colonization by Haemophilus influenzae and Haemophilus parainfluenzae in Children Undergoing Adenoidectomy and the Ability of Bacterial Isolates to Biofilm Production. — Kosikowska U, Korona-Głowniak I, Niedzielski A, Malm A Medicine (2015)
[16]
Group A β-hemolytic streptococcal pharyngotonsillitis outbreak. — Culqui DR, Manzanares-Laya S, Van Der Sluis SL, Fanlo AA, Comas RB, Rossi M et al. Revista de saude publica (2014)
[17]
Prevalence of β-hemolytic Streptococcus in children with special health care needs. — Morais VM, Orsi AR, Maranhão FC, Castro TM, Castro KC, Silva DM Brazilian journal of otorhinolaryngology (2012)
[18]
A randomized, double-blind, placebo-controlled trial of paracetamol and ketoprofren lysine salt for pain control in children with pharyngotonsillitis cared by family pediatricians. — Ruperto N, Carozzino L, Jamone R, Freschi F, Picollo G, Zera M et al. Italian journal of pediatrics (2011)
[19]
Clinical scoring system of acute pharyngotonsillitis. — Togawa A, Hotomi M, Tamura S, Yamanaka N Advances in oto-rhino-laryngology (2011)
[20]
Rate of eradication of group A beta-hemolytic streptococci in children with pharyngo-tonsillitis by amoxicillin and cefdinir. — Brook I, Gober AE International journal of pediatric otorhinolaryngology (2009)
[21]
A scoring system for management of acute pharyngo-tonsillitis in adults. — Suzumoto M, Hotomi M, Billal DS, Fujihara K, Harabuchi Y, Yamanaka N Auris, nasus, larynx (2009)
[22]
Concurrent influenza A and group A beta-hemolytic streptococcal pharyngotonsillitis. — Brook I, Gober AE The Annals of otology, rhinology, and laryngology (2008)
[23]
Selected bacterial recovery in Trinidadian children with chronic tonsillar disease. — Pereira LMP, Juman S, Bekele I, Seepersadsingh N, Adesiyun AA Brazilian journal of otorhinolaryngology (2008)
[24]
T serotypes and antimicrobial susceptibilities of group A streptococcus isolates from pediatric pharyngotonsillitis. — Funahashi K, Nakane K, Yasuda N, Suzuki M, Narita A, Arai N et al. Japanese journal of infectious diseases (2008)
[25]
Antibiotic resistance pattern of group-a beta-hemolytic streptococci isolated from north Indian children. — Jain A, Shukla VK, Tiwari V, Kumar R Indian journal of medical sciences (2008)
[26]
Failure to eradicate streptococci and beta-lactamase producing bacteria. — Brook I, Gober AE Acta paediatrica (Oslo, Norway : 1992) (2008)
[27]
Ribosomal therapy in the prophylaxis of recurrent pharyngotonsillitis in children. — Mora R, Dellepiane M, Crippa B, Salami A International journal of pediatric otorhinolaryngology (2007)
[28]
Management of group A beta-hemolytic streptococcal pharyngotonsillitis in children. — Brook I, Dohar JE The Journal of family practice (2006)
[29]
Role of rapid antigen detection test for the diagnosis of group-A beta-hemolytic streptococcus in patients with pharyngotonsillitis. — Araujo Filho BC, Imamura R, Sennes LU, Sakae FA Brazilian journal of otorhinolaryngology (2006)
[30]
Oral clindamycin 300 mg BID compared with oral amoxicillin/clavulanic acid 1 g BID in the outpatient treatment of acute recurrent pharyngotonsillitis caused by group a beta-hemolytic streptococci: an international, multicenter, randomized, investigator-blinded, prospective trial in patients between the ages of 12 and 60 years. — Mahakit P, Vicente JG, Butt DI, Angeli G, Bansal S, Zambrano D Clinical therapeutics (2006)
[31]
Role of rapid antigen detection test for the diagnosis of group A beta-hemolytic streptococcus in patients with pharyngotonsillitis. — Araujo Filho BC, Imamura R, Sennes LU, Sakae FA Brazilian journal of otorhinolaryngology (2005)
[32]
Italian paediatricians and off-label prescriptions: loyal to regulatory or guideline standards? — Pandolfini C, Campi R, Clavenna A, Cazzato T, Bonati M Acta paediatrica (Oslo, Norway : 1992) (2005)
[33]
Penicillin V, loracarbef and clindamycin in tonsillar surface fluid during acute group A streptococcal pharyngotonsillitis. — Orrling A, Kamme C, Stjernquist-Desatnik A Scandinavian journal of infectious diseases (2005)
[34]
Intracellular survival of persistent group A streptococci in cultured epithelial cells. — Marouni MJ, Barzilai A, Keller N, Rubinstein E, Sela S International journal of medical microbiology : IJMM (2004)
[35]
Prevalence of the internalization-associated gene prtF1 in a bacterial population of Streptococcus pyogenes isolated from children with acute pharyngotonsillitis before and after antibiotic therapy. — Cocuzza CE, Lanzafame A, Sisto F, Broccolo F, Mattina R Microbial drug resistance (Larchmont, N.Y.) (2004)
[36]
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